﻿

<h1 style="text-align:center; background-color: #eee">
    <div style="text-align:center; margin:0px auto">
        <span id="title" style="font-size: xx-large">Send  Feedback</span>
        <div style="float:right">
            <a id="closeX" href="#">[x]</a>
        </div>
    </div>
</h1>
<div id="main">
    <div style="width: 100% ">
        <div style="width:100%">
            <div style="width:30%;float:left"><label>Subject: </label></div>
            <div style="width:60%; float:left">
                <input type="text" style="width:100%" />
            </div>
        </div>
        <div class="clearfix" style="width:100%; height:1px; clear:both"></div>
        <div style="width:100%">
            <div style="width: 30%; float: left"><label>Your name and/or email: </label></div>
            <div style="width: 60%; float: left">
                <input type="text" style="width:100%" />
            </div>
        </div>
        <div class="clearfix" style="width:100%; height:1px; clear:both"></div>
        <div style="width:100%">
            <div style="width: 30%; float: left"><label>Comment: </label></div>
            <div style="width: 60%; float: left">
                <textarea style="width:100%"></textarea>
            </div>
        </div>
        <div class="clearfix" style="width:100%; height:1px; clear:both"></div>
        <div style="width:100%">
            <div style="width: 60%; float: right">
                <button type="submit" id="btnSend">Send&nbsp;&rsaquo;&rsaquo;</</button>
            </div>
        </div>
    </div>
</div>
